Prostate cancer has become the most common form of cancer in American men and is the second-leading cause of cancer death in this population. According to the American Cancer Society, 1 in 6 men will be diagnosed with prostate cancer in their lifetime.
If a patient presents with a rising PSA or positive DRE, the urologist often offer a biopsy of the prostate to identify possible cancerous lesions. Traditionally, Twelve (12) biopsy cores would be obtained using Ultrasound guidance in order to adequately sample the gland. The biopsy sampling is performed in a standardized grid format in order to uniformly sample the gland. Detection in this manner is important especially if patients want to undergo nerve sparing or focal therapies designed to avoid long term complications of incontinence and impotence. This technique is not without their drawbacks. If the biopsies are negative or patient PSA is still rising, we now have new technology that provides the urologist with additional target specific methods in identifying potential abnormalities with increased accuracy.
Using MRI based URONAV fusion technology we can now visualize evaluate and identify suspicious lesions normally not seen or unreachable with the standard techniques. This technology allows for excellent delineation of the prostate and biopsies of suspicious lesions. UroNav Fusion biopsy can also be used for targeted assessment of suspicious lesions in patients undergoing surveillance for prostate cancer.
Recently, independent radiologists have begun to advertise and perform MRI guided biopsies to promote additional services in their centers claiming increased accuracy. Unfortunately, patients are dubiously undergoing these procedures without urologic supervision, accountability or structured algorithmic clinical pathways. They are subject to long periods of rectal probe insertion. Their accuracy is increased to 90-95% when there are targeted lesions (35% of all cases); however, 65% of all prostate cancers have diffuse disease without MRI focality. These patients would still need to undergo extended pattern biopsies by an urologist.
Urologists can now provide MRI based UroNav Fusion biopsies where biopsy can be performed on all targeted and non-targeted regions of the prostate. UroNav Fusion Biopsy increases the yield and accuracy of the biopsy to 98%. Furthermore, as urologist, we are able to manage any and all potential complications such as bleeding, infections, need for hospitalization. Urologist is also in a position to guide patients with equivocal cases. These issues are often neglected by independent radiologists and are often “dumped” back on the primary physicians or urologists. It is simply not in their arena of expertise.
- Primary Biopsy
- Negative prior TRUS Biopsy with rising PSA
- Positive DRE with Neg TRUS Biopsy
- Targeted Biopsy of patient with Prostate Cancer on Active Surveillance
BENEFITS TO PATIENTS:
- 95-98% Accuracy
- Targeted approach to an uncertain diagnosis after prostate exams
- Reduction in additional prostate biopsies
- Reduction in the amount and number of Biopsies
- Early detection
- Performed by Urologists positioned to manage all outcomes